A doctor who trains with the Advanced Regenerative Medicine Institute (ARMI) before going on to offer PRP therapy to patients learns a very exact process for treating chronic pain, osteoarthritis, and other conditions using blood platelets taken directly from the patient. ARMI is very particular about how doctors are trained. That’s good. But their training standards may not be the same as those implemented by a competing training company. As such, there is no single standard in the industry as of yet.
Some proponents of PRP therapy have been calling for industry standards for some time now. Those calls have been reinforced by a study published earlier in 2018 by Tissue Engineering Part A. The study demonstrated, among other things, that the volume and frequency of PRP injections can have a profound effect on their efficacy.
A typical PRP procedure for chronic osteoarthritis knee pain involves drawing blood from the patient. The blood is processed in a specialized centrifuge to concentrate platelets and growth factors. The resulting material is then injected into the painful joint with the expectation that it will trigger certain healing mechanisms that ultimately reduce pain.
What the Study Revealed
A group of researchers at the University of Pittsburgh decided to look at the efficacy of PRP therapy as a treatment for musculoskeletal injuries. They were particularly interested in whether the pain-relieving mechanism of the treatment actually contributes to the growth of new tissue.
Researchers set up a study in which they extracted autologous stem cells from two sources: bone marrow and adipose fat tissue. Both kinds of stem cells are mesenchymal stem cells science already knows are used by the body to generate cartilage. After injecting the stem cells into patients, the researchers followed up with PRP therapy in hopes of discovering how the cells would respond to the concentrated platelets and growth factors.
Their research revealed two things. First, the PRP material showed no ability to enhance the natural repair mechanisms of the stem cells. Second, the stem cells were less effective when high volumes of PRP material were introduced. Researchers concluded that not only does PRP material not induce tissue growth in and of itself, but it can actually hinder tissue growth if there’s too much of it introduced in too short a time.
Growth Factors Are Multi-Functional
Following the research, the team went on to explain that the growth factors associated with blood platelets are multi-functional. They absolutely do contribute to new tissue growth by providing some of the base materials necessary for such growth. But they also stimulate other cellular activities including vascularization, cell adhesion, cell migration, and even cell death.
This explains why an excess volume of PRP material can actually hinder healing in patients suffering from musculoskeletal disease or injuries. You can have too much of a good thing when it comes to PRP injections.
Volume, Frequency, and Injection Sites
The study serves as a reminder of the need for new research into the way PRP therapy is administered. It is time for science to look at the frequency of PRP injections, the volume of the material to be used, and how injection sites are chosen. It is time to start collecting hard data that will help the industry set some standards that maximize the efficacy of PRP treatment for every patient.
Until such standards exist, doctors will continue receiving non-standardized training. Their patients will receive non-standardized care. PRP therapy that works for some patients but not for others will be the end result. The regenerative medicine industry can, and should, do better.